Labor dispute could affect staffing at New Hampshire Hospital

A labor dispute involving doctors at New Hampshire Hospital could jeopardize whether the state-run psychiatric facility in Concord has a complete medical staff in place this summer.

“As of July 1, New Hampshire Hospital does not have a psychiatric staff,” said Dr. Matthew Davis, who has worked at New Hampshire Hospital for the last four years.

While most of the staff at New Hampshire Hospital are state employees, 19 psychiatrists, advanced-level nurses and administrators work there under contract. Dartmouth College’s Geisel School of Medicine has had the contract since 1988, but the latest contract expires June 30.

Dartmouth-Hitchcock is seeking to take over the state agreement. The health care organization hoped to hire the 19 Geisel workers to staff the hospital, but so far only six have signed on.

The remaining 13 psychiatrists and nurses, including Davis, have formed their own practice group – the Psychiatric Professionals of New Hampshire – and are trying to compete for the state contract.

Davis said Dartmouth-Hitchcock’s compensation and benefits package was unfair and the organization was unwilling to negotiate. The group had tried to unionize, but its petition was dismissed by the National Labor Relations Board in April.

“We don’t want to leave,” Davis said. “This is a crisis entirely of the making of these large corporations that are grossly mistreating their employees.”

Dartmouth-Hitchcock officials disagree and said its employment offers were “very generous.” Dartmouth-Hitchcock proposed to pay New Hampshire Hospital staff at the same level, if not more, and agreed to recognize years of service for retirement purposes, according to John Kacavas, chief legal officer for Dartmouth-Hitchcock.

“We find it incredibly unfortunate,” he said. “We would have loved to have these people accept our generous offer of employment, but they have elected not to do that.”

Davis said Dartmouth-Hitchcock’s proposal reduced time off, lowered retirement benefits and eliminated a salary bump for employees who turn 40. Neither side provided the employment offer to the Monitor for inspection.

New Hampshire Hospital has faced staffing problems over the past year. It had to delay the opening of a new 10-bed mental health crisis unit because of a nursing shortage. Meanwhile in March, the psychiatric hospital saw record high numbers of people waiting to get admitted to one of its 158 beds.

The state contract calls for a winning bidder to provide more than 20 psychiatrists, nurses and administrative staff to New Hampshire Hospital. Darmouth-Hitchcock is now recruiting to fill the remaining positions it needs to satisfy the agreement, Kacavas said. But he wouldn’t say whether those efforts have proven successful.

“We are confident we are going to fulfill the terms of the contract if we’re awarded it,” Kacavas said. “Our concern, our No. 1 concern, is patient care at New Hampshire Hospital.”

Darmouth-Hitchcock was the only organization that submitted a bid by the April 15 deadline to provide psychiatric services at New Hampshire Hospital.

The state Department of Health and Human Services has yet to announce whether Dartmouth-Hitchcock has won the contract or whether the state will reopen the bidding process and accept new proposals. The Psychiatric Professionals of New Hampshire is hoping that happens so the practice group can compete, Davis said.

Any contract needs sign-off from the five-member Executive Council.

Jake Leon, spokesman for HHS, said he expects a new contract be in place July 1 “to ensure that patients will continue to receive the services so essential to their health and safety.”

“As with any DHHS contract, the provider of clinical services is responsible for the services specified in the contract today and the provider that is awarded the next contract will be expected to meet those terms beginning July 1,” Leon said.

A spokesman for Gov. Maggie Hassan wouldn’t say whether she is involved in the process. But he did say that a well-trained staff at New Hampshire Hospital is a “paramount concern” to the state.